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WASHINGTON , DC 20510

December 7, 2016
President-Elect Donald J. Trump
Trump Tower
725 5th Ave
New York, NY 10022
Dear President-Elect Trump:
We are writing to you to express our strong concerns that you have been remarkably inconsistent
in your important campaign promise to protect and defend the Medicare and Medicaid programs and
appear now to support policies that endanger the Medicare and Medicaid benefits that provide health
care to tens of millions of seniors, people with disabilities, and low- and middle-income Americans.
The nomination of Congressman Tom Price for Secretary of Health and Human Services underscores
this concern.
During your campaign for President of the United States, you differentiated yourself from your
16 primary opponents by noting that you were the only Republican who would protect Medicare and
Medicaid. After winning the election, you suddenly appear to be using language supporting policies that
would gut the Medicare and Medicaid programs.
You could not have been clearer during the campaign about your opposition to program cuts to
our nation's bedrock health care programs. You~ campaign website proudly trumpeted that "Donald
Trump won't touch your entitlements," and you claimed that "every other Republican is going to cut
[these programs]," but "I'm not going to cut Medicare or Medicaid" (Figure 1). 1 It touted coverage that
you "would exclude entitlement costs" from cuts to government spending (Figure 2). 2 It stated your
policy in plain language: "Do not cut ... Medicare benefits." And it rightly noted that "most Americans
want to keep the benefits as they stand now" (Figure 3). 3
This is the right policy. Over one hundred million Americans rely on these programs for health
care. Low-income children and families and people with disabilities are the primary beneficiaries of
Medicaid. Millions of seniors and individuals with disabilities have earned and rely on their Medicare
benefits. Medicaid is the only assistance available to millions of low and middle-income families who
have a loved one requiring nursing home care. As you noted when you extolled their benefits on your
campaign website, cutting these programs would be devastating.

Donald J. Trump for President, "Why Donald Trump Won't Touch your Entitlements" (May 21, 2015)
(https://www.donaldjtrump.com/media/why-donald-trump-wont-touch-your-entitlements).
2 Donald J. Trump for President, "Donald Trump Lays Out More Details of Economic Plan" (September 15, 2016)
(https://www.donaldjtrump.com/media/donald-trump-lays-out-more-details-of-economic-plan).
3 Donald J. Trump for President, "What Does Donald Trump Believe? Where the Candidate Stands on 10 Issues"
(June 16, 2015) (https://www.donaldjtrump.com/media/what-does-donald-trump-believe-where-the-candidate-stands-on- I 0issues).
1

But your transition website has eliminated your earlier assurances and blatantly disregards the
promises you repeatedly made during the campaign and instead now calls for sweeping changes to
Medicare and Medicaid. As it currently stands, your transition team's policy proposals are shrouded in
benign-sounding cliches that promise to "modernize" and "maximize flexibility" for the programs. But
Americans who are watching closely can see your plans for what they are: a poorly-veiled regurgitation
of the plans, supported by Republicans in the House and Senate, to gut Medicare and Medicaid. 4 Your
nominee for the Secretary of Health and Human Services is a leading architect of these plans.
Your transition website states that you will "Modernize Medicare so it will be ready for ... the
coming retirements of the Baby Boom generation- and beyond." And it indicates that you will
overhaul Medicaid to "Maximize flexibility for states to ... experiment with innovative methods to
deliver healthcare to our low-income citizens" (Figure 4). 5 These statements are nearly identical to the
healthcare reform language in Speaker Ryan's "Better Way" healthcare reform plan, which states: "Our
plan maximizes state flexibility" and provides incentives for states to find "innovative ways to reduce
Medicaid costs." 6 And on Medicare, the same report commits to: "moderniz[e] the program to reflect
the changes to health care delivery in the 21st century" by "gradually increase[ing] the Medicare
retirement age."
House Republicans have been bracingly clear: they intend to work with you to pass these cuts.
Reports indicate that Speaker Paul Ryan "is promoting his 'A Better Way Agenda' as a guide for
Trump" on "health care" and other issues. 7 And Representative Sean Duffy stated that "it's almost a
plug and play scenario." 8
These Republican plans would be devastating for millions of Americans. They would increase
the Medicare eligibility age. 9 They would privatize Medicare, replacing guaranteed benefits with
vouchers that seniors would be forced to use to purchase coverage, dramatically increasing out-ofpocket costs. 10 They would cut billions of dollars from the Medicaid program, turning the program into
a "block grant" that would force states to eliminate coverage for millions of beneficiaries, cut guaranteed
benefits and consumer protections, and slash provider payments. 11

Speaker of the House Paul Ryan, A Better Way (2016) (http://abetterway.speaker.gov/?page=health-care).

President-Elect Donald J. Trump, Healthcare (November 16, 2015)
(https://www.greatagain.gov/policy/healthcare.html).
6 Speaker of the House Paul Ryan, "A Better Way: Health Care" (June 22, 2016)
(http ://abetterway. speaker.govI assets/pdfl ABetter Way-HealthCare-Po licyPaper.pdt) .
7 Philip Rucker and Robert Costa, "In Trump's Washington, Rival Powers and Whispers in the President's Ear," The
Washington Post (November 16, 2016) (https://www.washingtonpost.com/politics/in-trumps-washington-rival-powers-andwhispers-in-the-presidents-ear/20 l 6/ l l / l 6/50f3306c-ac03- l l e6-a3 l b-4b6397e625d0 story.html).
8 Philip Rucker and Robert Costa, "In Trump's Washington, Rival Powers and Whispers in the President's Ear," The
Washington Post (November 16, 2016) (https://www.washingtonpost.com/politics/in-trumps-washington-rival-powers-andwhispers-in-the-presidents-ear/20 l 6/1 l/16/50f3306c-ac03-11 e6-a31 b-4b6397e625d0 story.html).
9 Speaker of the House Paul Ryan, "A Better Way: Health Care" (June 22, 2016)
(http ://abetterway.speaker. govI assets/pd fl A BetterWay-HealthCare-Po !icyPaper. pdt) .
10 Janet Novack, "Will President Trump Cut Medicare and Social Security As Well As Taxes?" Forbes (November
10, 2016) (http://www.forbes.com/sites/janetnovack/2016/11/1O/will-president-trump-cut-medicare-and-social-security-aswell-as-taxes/#6de64500a43 t). Michael Hiltzik, "Paul Ryan Is Determined to Gut Medicare. This Time He Might Succeed,"
The Los Angeles Times (November 14, 2016) (http://www.latimes.com/business/hiltzik/la-fi-hiltzik-medicare-ryan20161114-story.html).
11 Huffington Post, Not Just Obamacare: Medicaid, Medicare Also on GOP's Chopping Block (Nov.15, 2016)
(http://www.huffingtonpost.com/entry/obamacare-medicaid-medicare-gop-choppingblock_us_582al 9b8e4b060adb56fbae7).
4

Enacting these cuts to Medicare and Medicaid would devastate millions of middle- and lowincome seniors and families, and break your promise to the American people that you would "not ... cut
Medicare or Medicaid."
But now it seems you have reversed course on your promises to protect Medicare and Medicaid
and instead plan to dismantle these programs.
It's not too late to fix this problem. We ask that you rapidly and publicly clarify in plain
language for the American public that you continue to stand behind your campaign promises; that you
will not raise the Medicare eligibility age; that you will not privatize, voucherize, or otherwise cut
Medicare benefits; and that you will not put in place changes to Medicaid that force enrollees' coverage
to be dropped and benefits to be cut or limited. You promised Americans you would not cut Medicare
or Medicaid-please tell Americans you will stand by your promise to them.
Sincerely,

United States Senator

Patty MU
United States Senator

United States Senator

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Bernard Sanders
United States Senator

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United States Senator

United States Senator

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United States Senator

United States Senator

Tom Udall
United States Senator

Brian Schatz
United States Senator

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Kirsten Gillibrand
United States Senator

Richard Blumenthal
United States Senator

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United States Senator

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Robert P. Casey, Jr.
United States Senator

Al Franken
United States Senator

United States Senator

Maria Cantwell
United States Senator

United States Senator

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Donald Trump says if he runs for president he'll make sure entitJement programs

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